The U.S. Department of Defense's (DOD) Defense Advanced Research Projects Agency (DARPA) has been working with a medical company that can help soldiers survive internal abdominal injuries and internal hemorrhaging.

The DOD strives to accomplish what is known as the "Golden Hour," which transports a wounded soldier to a medical facility in under an hour. However, for those suffering from internal abdominal injuries and internal hemorrhaging, their chances of surviving an entire hour with a large amount of blood loss are quite slim.

Currently, there are limited solutions for temporarily taking care of internal hemorrhaging while transporting a soldier to the hospital. Internal wounds cannot be compressed, and tourniquets and hemostatic dressings cannot be used due to the need to see the actual injury.

To address this issue, DARPA started the Wound Stasis System program in 2010. Through the program, it found Arsenal Medical, Inc., which developed the new foam method.

This is how the foam works: two liquid phases are injected into the abdominal cavity. The first liquid phase is a polyol phase, and the second is a isocyanate phase. When these two liquids are combined, they two different reactions take place. The first expands the liquid to about 30 times its original volume where it fits the surfaces of the injured tissue. The second transforms the liquid into solid foam, which becomes a polyurethane polymer. It is capable of resisting intra-abdominal blood loss, and can expand through both pooled and clotted blood.

The foam, which can be quickly and easily removed by doctors once the soldier is taken to the medical facility, can reduce blood loss six-fold and heighten the rate of survival at three hours post-injury to 72 percent. This number was at 8 percent without the foam. The foam showed that it could treat a lethal liver injury for three hours before reaching medical treatment.

“Wound Stasis has been an exciting program because we were able to move unexpectedly from fundamental research to a pre-clinical proof-of-concept based on the strength of our findings,” said Brian Holloway, DARPA program manager. “According to the U.S. Army Institute of Surgical Research, internal hemorrhage is the leading cause of potentially survivable deaths on the battlefield, so the Wound Stasis effort should ultimately translate into an increased rate of survival among warfighters. If testing bears out, the foam technology could affect up to 50 percent of potentially survivable battlefield wounds. We look forward to working with the U.S. Food and Drug Administration on future regulatory submission of this device, and with our partners, the Army Institute of Surgical Research and Special Operations Command, on getting this technology to where it’s desperately needed on the front lines.”

DARPA gave Arsenal Medical, Inc. $15.5 million for Phase II of foam development.

Exciting development indeed, but just one observation I have. Unless the person injecting this stuff is a trained medical personnel with some imaging guidance aide, such as ultrasound, which is unlikely in the battlefield, how are they sure they are not puncturing into bowel or some other hollow viscus instead of the peritoneum? And yes, it's quite easy to get bowel instead of peritoneum if there is not much ascites in the belly. Imaging injecting this into a small bowel loop or colon and have it expand to the point of rupture. Catastrophe.

Veress needles, which are done essentially blindly, are placed at the beginning of tens of thousands of laparoscopic cases. They essentially have a needle that's extended when penetrating through the muscle (fascia) layers and retracts when there's a loss of resistance (i.e. entering the peritoneum). Bowel / vascular injuries happen, but are pretty rare.

If the stuff really is as good as they say, it might be worth the risk. After all, if you're getting this, chances are you're bleeding to death and getting a laparotomy anyways. Colon/small bowel injuries are probably the least of your problems.